不同病情高胆红素血症新生儿血清AST、IGF-1、NSE、CysC水平的表达及临床意义

Expression and Clinical Significance of Serum AST,IGF-1,NSE and CysC Levels in Neonates with Hyperbilirubinemia

目的:研究不同病情高胆红素血症新生儿血清谷草转氨酶(AST)、胰岛素样生长因子-1(IGF-1)、神经元特异性烯纯化酶(NSE)、胱抑素C(CysC)水平的表达及临床意义。方法:将我院从2017年1月2018年12月收治的高胆红素血症新生儿316例作为研究组。按其病情分成轻度组152例、中度组105例以及重度组59例,另取同期健康新生儿100例作为对照组。比较四组新生儿血清AST、IGF-1、NSE、CysC、总胆红素(TSB)水平,分析上述各项指标的关系。此外,比较对照组与研究组的基线资料,分析新生儿高胆红素血症发病的影响因素。结果:轻度组、中度组、重度组血清AST、IGF-1、NSE、CysC、TSB水平均高于对照组,且中度组、重度组上述指标高于轻度组,重度组上述指标高于中度组(P<0.05)。经Pearson相关性分析可得:高胆红素血症新生儿TSB水平与血清AST、IGF-1、NSE、CysC水平均呈正相关(P<0.05)。研究组和对照组在母婴血型不合、产前使用催产素、围生期疾病以及TSB、AST、IGF-1、NSE、CysC方面对比差异均有统计学意义(P<0.05)。经多因素Logistic回归分析可得:新生儿高胆红素血症发病的影响因素为产前使用催产素、围生期疾病以及TSB、AST、IGF-1、NSE、CysC(P<0.05)。结论:随着高胆红素血症新生儿病情的加剧,血清AST、IGF-1、NSE、CysC水平均逐渐升高且均与血清TSB水平呈正相关,临床工作中可能通过联合检测上述血清学指标辅助评估高胆红素血症新生儿病情,且以上指标水平的升高会增加新生儿高胆红素血症的发病风险。

Objective:To study the expression and clinical significance of serum glutamate aminotransferase(AST),insulin-like growth factor-1(IGF-1),neuron-specific enolase(NSE),cystatin C(CysC)levels in neonates with hyperbilirubinemia.Methods:316 neonates with hyperbilirubinemia who were admitted to our hospital from January 2017 to December 2018 were referred to as the research group.According to the different conditions,they were divided into 152 cases in the mild group,105 cases in the moderate group and 59 cases in the severe group.Another 100 healthy newborns at the same time were selected as the control group.Serum AST,IGF-1,NSE,CysC and total bilirubin(TSB)levels in the 4 groups were compared,analyzed the relationship between the above indicators.Baseline datas of control group and study group were compared,the influencing factors of neonatal hyperbilirubinemia were analyzed.Results:Serum AST,IGF-1,NSE,CysC and TSB levels in the mild group,the moderate group and the severe group were higher than those in the control group,and those in the moderate group and the severe group were higher than those in the mild group,while those in the severe group were higher than those in the mild group(P<0.05).Pearson correlation analysis showed that TSB level of neonates with hyperbilirubinemia were positively correlated with serum AST,IGF-1,NSE and CysC levels(P<0.05).There were statistically significant differences between the study group and the control group in maternal and infant blood group incompatibility,prenatal use of oxytocin,perinatal diseases and TSB,AST,IGF-1,NSE,CysC(P<0.05).The influencing factors of neonates with hyperbilirubinemia were prenatal use of oxytocin,perinatal diseases,TSB,AST,IGF-1,NSE,CysC(P<0.05).Conclusion:With the aggravation of neonates with hyperbilirubinemia,serum AST,IGF-1,NSE and CysC levels gradually increased,and were positively correlated with the TSB level.In clinical work,it is possible to assess the condition of neonates with hyperbilirubinemia by combining the above serological indicators.And the increase of the above indicators will increase the risk of neonates with hyperbilirubinemia.